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Crucial Controversies in Surgery, Volume 3
sections, ranging from cardiorespiratory arrest in children to premalignant vulval disorders in women. Each section begins with a summary page that includes the question, interventions to be addressed, key messages, definitions, incidence, prevalence, etiology/risk factors, prognosis, aims, outcomes, and methods. Interventions are then posed as options to the questions, and the benefits and harms are discussed in complete detail. Comments, appropriate glossaries, any substantive changes since the last issues, and references follow the thorough discussion of either supporting or nonsupporting clinical trial evidence. Easily readable tables and graphs accompany many of the sections. The chapters cover a broad range of topics in a readable manner, and the predetermined format makes the text less distracting when reading it. The most relevant topics and questions were addressed in greater detail, whereas the more obscure topics and questions were covered in lesser detail. The chapters were well referenced, and the book was well indexed. A very limited, yet colorful appendix is found at the back of the journal. Several topics have been expanded, including asthma, antenatal care in low risk pregnancies, and nonmetastatic breast cancer. Newly included interventions are labeled on the summary page for each topic. All topics from Issue 2 were reedited to make them clearer. This reediting sometimes meant promoting or demoting an intervention from one summary category to another. Future issues that Clinical Evidence will be rectifying include the following: firmer criteria for categorizing interventions, more systematic searches and presentation of data on the harmful effects of interventions, clearer discussion of how the evidence relates to different groups of people, provision of more global data on prevalence and incidence, and the inclusion of questions on diagnostic strategies. Individual subscribers receive full text Internet access as part of an annual subscription (www.clinicalevidence.com). The annual subscription cost ($280/year) is a bit pricey for most medical students and residents who have limited textbook funds. In brief, although expensive, Clinical Evidence would be a good investment for all departments, not just family or internal medicine. Obstetrics/gynecology and surgery departments would also benefit from this comprehensive journal.
Controversial surgical issues not only occur within departments, but also can occur between regions and even across oceans. In Crucial Controversies in Surgery, Volume 3, Schein
and Wise provide a thorough discussion on current controversial topics in surgery. Surgical controversies are as numerous and varied as the divergent opinions offered by the surgeons involved in them. Certain topics, by their inherent complexity or the frequency with which they arise at weekly morbidity and mortality conferences, can be considered high yield. Ranging from general to vascular to oncologic surgery, the arguments presented expand beyond the individual surgeon’s ritual and allow for education and enlightenment of the reader. Using the compare-and-contrast method, the editors have collected dynamic discussions on 15 varied topics relevant to the practicing surgeon. Inviting distinguished surgeons from both the United States and Canada, as well as their esteemed counterparts from across the Atlantic and Pacific oceans, the editors have provided a work with an international scope. Each chapter presents a new surgical controversy. Most chapters begin with a detailed presentation of an individual surgeon’s or group’s current treatment, method, or practice related to the chapter topic. This is followed by 1 or 2 invited commentaries by a surgeon or group who may agree or disagree with the initial presentation. Each chapter concludes with a brief editorial comment highlighting the strengths and weaknesses of each position. Structuring the arguments in this format provides completeness to the debate surrounding each controversy. The topics provide a substantial cross section of surgical disease encountered daily by the general surgeon. The 15 topics include Evidence-Based Surgery, Surgical-Technical Education, Surgical Wound Management, ICU-Acquired Infections, Small Bowel Obstruction, Obstructive Jaundice, Acute Diverticulitis, Ventral-Incisional Hernia, Hepatic Metastases, Pancreatic Pseudocysts, Parathyroid, Aortic Abdominal Aneurysm, Carotid Artery Occlusive Disease, Acute Limb Ischemia, and Thromboembolic Venous Disease. The text is formatted in an easily readable style and chapter length averages 15 to 20 pages. The chapters lend themselves to the between-case and evening read times. Most of the subjects chosen for review are relevant to the everyday practice of surgery. The 2 chapters concerning Evidence-Based Surgery and Surgical-Technical Education were thorough and well written, but for me, uninteresting. However, the chapter concerning surgical wound management will be extremely helpful to the young house officer. Within 2 days of reading the chapter, I had the opportunity to manage a patient with an infected groin wound and an underlying graft, 1 of the scenarios presented in this chapter. The complications and decisions made in the care of this patient paralleled the concerns and issues that the text had outlined. As with any compilation work, certain subjects are better presented and defended than are other subjects. Overall, I found this book to be useful for defining the arguments on each side of the controversy. The text is most appropriate for the surgical resident or the newly graduated attending surgeon. Although senior-level attendings may enjoy the presentation of the varying arguments, they will probably not be swayed from their customary protocol. However, young sur-
CURRENT SURGERY • Volume 58/Number 4 • July/August 2001
377
SHAWN DALTON-BETHEA, MD Brody School of Medicine East Carolina University Greenville, North Carolina PII S0149-7944(01)00445-7
Crucial Controversies in Surgery, Volume 3 Schein M, Wise L, eds. Philadelphia, Pa: Lippincott Williams & Wilkins, 1999, 336 pp, $49.95.
geons can use the text to improve their approach to the management of the above-mentioned surgical diseases. TODD MILLER, MD Department of Surgery Lehigh Valley Hospital Allentown, Pennsylvania PII S0149-7944(01)00447-0
Mitral Valve: Floppy Mitral Valve, Mitral Valve Prolapse, Mitral Valvular Regurgitation, 2nd ed Boudoulas H, Wooley CF, eds. Armonk, NY: Futura, 2000, 753 pp, $145.00. When asked to review this text, I was pleasantly surprised by the content and style of this comprehensive tome. The editors and over 30 other contributors introduce each chapter with a short preface. The chapters are generally clear and well written. Illustrations and diagrams are of high quality. All figures and photographs are in black and white, except for a selected few that are attached in a “Color Appendix.” Grammatical errors are few. The breadth of this book is apparent from the table of contents. A full spectrum of issues regarding the floppy mitral valve is reviewed from the perspective of morphologists, geneticists, echocardiographers, cardiologists, surgeons, and, interestingly, a veterinarian. Drs. Boudoulas and Wooley exert considerable effort to detail the historical aspects of mitral valve prolapse. For students of medical history, this text is full of interesting anecdotes, mistaken ideas and therapies, and interesting personalities that chronicle floppy mitral valve disease from the late 1800s until the present time.
378
As a cardiac surgeon with over 20 years experience with mitral valve disease, I found the chapters on mitral valve physiology, anatomy, and pathophysiology particularly fascinating. I was disappointed that only 1 of the 27 book chapters was devoted to surgical reconstruction of the floppy mitral valve. Also, only 1 chapter is devoted to intraoperative transesophageal echocardiogram assessment of the mitral valve. Drs. Larry Cohn and Ross Reul do a yeoman’s job of outlining the surgical issues. Many thorny topics in mitral valve repair, such as “when is it too late to offer a patient mitral valve repair,” the decision regarding when to combine mitral valve repair with other cardiac procedures, and certain technical controversies regarding repair are alluded to, but not explored in depth. This is a disappointment to me in a text that is rich in so many other areas. Some chapters deal with the floppy mitral valve in athletes, aviators, pregnant women, as well as the Japanese experience with mitral valve prolapse and the veterinarian’s experience! As a surgeon, I would have appreciated a more thorough explanation of surgical and technical issues. In summary, I enjoyed this text far more than I anticipated. Upon first flipping the book open, one is daunted by its size and seeming complexity. However, once into a chapter, the reader is drawn along by the easy style and readability of the text. I believe that many physicians of diverse backgrounds will enjoy this work. TERRILL E. THEMAN, MD Department of Surgery St. Luke’s Hospital Bethlehem, Pennsylvania PII S0149-7944(00)00428-1
CURRENT SURGERY • Volume 58/Number 4 • July/August 2001
Controversial surgical issues not only occur within departments, but also can occur between regions and even across oceans. In Crucial Controversies in Surgery, Volume 3, Schein
and Wise provide a thorough discussion on current controversial topics in surgery. Surgical controversies are as numerous and varied as the divergent opinions offered by the surgeons involved in them. Certain topics, by their inherent complexity or the frequency with which they arise at weekly morbidity and mortality conferences, can be considered high yield. Ranging from general to vascular to oncologic surgery, the arguments presented expand beyond the individual surgeon’s ritual and allow for education and enlightenment of the reader. Using the compare-and-contrast method, the editors have collected dynamic discussions on 15 varied topics relevant to the practicing surgeon. Inviting distinguished surgeons from both the United States and Canada, as well as their esteemed counterparts from across the Atlantic and Pacific oceans, the editors have provided a work with an international scope. Each chapter presents a new surgical controversy. Most chapters begin with a detailed presentation of an individual surgeon’s or group’s current treatment, method, or practice related to the chapter topic. This is followed by 1 or 2 invited commentaries by a surgeon or group who may agree or disagree with the initial presentation. Each chapter concludes with a brief editorial comment highlighting the strengths and weaknesses of each position. Structuring the arguments in this format provides completeness to the debate surrounding each controversy. The topics provide a substantial cross section of surgical disease encountered daily by the general surgeon. The 15 topics include Evidence-Based Surgery, Surgical-Technical Education, Surgical Wound Management, ICU-Acquired Infections, Small Bowel Obstruction, Obstructive Jaundice, Acute Diverticulitis, Ventral-Incisional Hernia, Hepatic Metastases, Pancreatic Pseudocysts, Parathyroid, Aortic Abdominal Aneurysm, Carotid Artery Occlusive Disease, Acute Limb Ischemia, and Thromboembolic Venous Disease. The text is formatted in an easily readable style and chapter length averages 15 to 20 pages. The chapters lend themselves to the between-case and evening read times. Most of the subjects chosen for review are relevant to the everyday practice of surgery. The 2 chapters concerning Evidence-Based Surgery and Surgical-Technical Education were thorough and well written, but for me, uninteresting. However, the chapter concerning surgical wound management will be extremely helpful to the young house officer. Within 2 days of reading the chapter, I had the opportunity to manage a patient with an infected groin wound and an underlying graft, 1 of the scenarios presented in this chapter. The complications and decisions made in the care of this patient paralleled the concerns and issues that the text had outlined. As with any compilation work, certain subjects are better presented and defended than are other subjects. Overall, I found this book to be useful for defining the arguments on each side of the controversy. The text is most appropriate for the surgical resident or the newly graduated attending surgeon. Although senior-level attendings may enjoy the presentation of the varying arguments, they will probably not be swayed from their customary protocol. However, young sur-
CURRENT SURGERY • Volume 58/Number 4 • July/August 2001
377
SHAWN DALTON-BETHEA, MD Brody School of Medicine East Carolina University Greenville, North Carolina PII S0149-7944(01)00445-7
Crucial Controversies in Surgery, Volume 3 Schein M, Wise L, eds. Philadelphia, Pa: Lippincott Williams & Wilkins, 1999, 336 pp, $49.95.
geons can use the text to improve their approach to the management of the above-mentioned surgical diseases. TODD MILLER, MD Department of Surgery Lehigh Valley Hospital Allentown, Pennsylvania PII S0149-7944(01)00447-0
Mitral Valve: Floppy Mitral Valve, Mitral Valve Prolapse, Mitral Valvular Regurgitation, 2nd ed Boudoulas H, Wooley CF, eds. Armonk, NY: Futura, 2000, 753 pp, $145.00. When asked to review this text, I was pleasantly surprised by the content and style of this comprehensive tome. The editors and over 30 other contributors introduce each chapter with a short preface. The chapters are generally clear and well written. Illustrations and diagrams are of high quality. All figures and photographs are in black and white, except for a selected few that are attached in a “Color Appendix.” Grammatical errors are few. The breadth of this book is apparent from the table of contents. A full spectrum of issues regarding the floppy mitral valve is reviewed from the perspective of morphologists, geneticists, echocardiographers, cardiologists, surgeons, and, interestingly, a veterinarian. Drs. Boudoulas and Wooley exert considerable effort to detail the historical aspects of mitral valve prolapse. For students of medical history, this text is full of interesting anecdotes, mistaken ideas and therapies, and interesting personalities that chronicle floppy mitral valve disease from the late 1800s until the present time.
378
As a cardiac surgeon with over 20 years experience with mitral valve disease, I found the chapters on mitral valve physiology, anatomy, and pathophysiology particularly fascinating. I was disappointed that only 1 of the 27 book chapters was devoted to surgical reconstruction of the floppy mitral valve. Also, only 1 chapter is devoted to intraoperative transesophageal echocardiogram assessment of the mitral valve. Drs. Larry Cohn and Ross Reul do a yeoman’s job of outlining the surgical issues. Many thorny topics in mitral valve repair, such as “when is it too late to offer a patient mitral valve repair,” the decision regarding when to combine mitral valve repair with other cardiac procedures, and certain technical controversies regarding repair are alluded to, but not explored in depth. This is a disappointment to me in a text that is rich in so many other areas. Some chapters deal with the floppy mitral valve in athletes, aviators, pregnant women, as well as the Japanese experience with mitral valve prolapse and the veterinarian’s experience! As a surgeon, I would have appreciated a more thorough explanation of surgical and technical issues. In summary, I enjoyed this text far more than I anticipated. Upon first flipping the book open, one is daunted by its size and seeming complexity. However, once into a chapter, the reader is drawn along by the easy style and readability of the text. I believe that many physicians of diverse backgrounds will enjoy this work. TERRILL E. THEMAN, MD Department of Surgery St. Luke’s Hospital Bethlehem, Pennsylvania PII S0149-7944(00)00428-1
CURRENT SURGERY • Volume 58/Number 4 • July/August 2001